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NPI Code Detail

MEDICARE: DR. GREGG WENDELL SCHELLACK D.O.

MEDICARE: DR. GREGG WENDELL SCHELLACK D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianPHYS-35111MT

General Provider Information

NPI Number : 1205887544
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGG WENDELL SCHELLACK D.O.
Provider Business Mailing Address
First Line : 320 ALPENGLOW LN
Second Line :
City : LIVINGSTON
State : MT
Zip : 59047-8506
Country : US
Telephone Number : 406-222-3541
Fax Number : 406-222-7606
Provider Business Practice Location Address
First Line : 320 ALPENGLOW LN
Second Line :
City : LIVINGSTON
State : MT
Zip : 59047-8506
Country : US
Telephone Number : 406-222-3541
Fax Number : 406-222-7606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 08/21/2024

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